Thoughts on Tobacco, Evolution, Sustainability & Strategic Planning

Healthcare Reform Has Started to Change Our World

It seems I’ve been a public health professional for almost a quarter of a century. (really? wow) I’ve gotta say, in those 24 years, one of the things that gives me the most optimism is the advent of health care reform. Cutting through the details, health care reform is fundamentally shifting to being more logical about our health, particularly finally investing more in avoiding problems, instead of just fixing them. When I was in school, we used to describe public health like this; if you’re next to a river and people keep coming down drowning, the doctors will pull them out and resuscitate them, but the public health officials will head upstream to help stop them from falling in. Finally now, our health care system is moving towards that upstream intervention. It took spiraling healthcare costs to spur the shift, a burden that our kids will probably have to keep paying, but at least it’s happening.

85% Is Good News for Us

A while ago folk at CDC started to throw out a startling stat, seems the analysts crunched the numbers and came up with the fact that if we do a better job of avoiding smoking, eating better, and exercising more as a country, we can cut our healthcare costs by a whopping 85%. Eighty five percent, that’s just shocking. Yes, it’ll take a boatload of changes to really shift these 3 health behaviors, but it’s numbers like this that are spurring the 3/4 of a billion dollars the government recently invested in Community Transformation Grants aimed at these three issues. This is all good news for anyone working in tobacco, or in healthy eating or exercise. As the ex-head of CDC’s Office of Smoking and Health said, “We kept saying smoking was important, finally they realized we were even more important than anyone guessed.”

Fewer Silos, More Grain

Hold on, hold on, there’s even more logic coming out of the government. (I know, we try not to expect that). Along with the shift towards more wellness/prevention work, there’s also a lot of reorganization afoot, to combine funding streams to allow more integrated work on the three areas: tobacco, exercise, and healthy eating. Yah, not only does this probably reduce paperwork for someone (not that you could tell from any of the proposals I’ve written recently), but it also just makes sense. If we’re trying to help people be healthier, do we really want several sets of people locally trying to change things, one for tobacco, another for healthy eating, and another urging folk to exercise. Of course not, the concept of pushing Wellness as an integrated focus makes the most sense.

Evolution and Pain

As most of you know, it was this shift that spurred our move about a year ago to change our name from the National LGBT Tobacco Control Network, to the less issue-specific Network for LGBT Health Equity. We knew future funding would come out with a tobacco/eating/exercise combined focus and we wanted to ensure the Network would be ready to compete in the evolving world. Unfortunately, for a group that’s always been community driven, we dropped the ball on the name change, not announcing the opportunities for input widely enough to our membership. While most everyone was very supportive of the name change, some vocal and longtime members were upset. Worrying that we would lose our tobacco focus in the shift. I hope the ensuing time has proven our continued focus on tobacco. It is after all, the only thing we’re funded to address. But I also hope we’ve showed we can be relevant to the other health issues as well, because we really do understand much of our work in tobacco can be useful to other arenas.

Sustainability & Strategic Planning

The Network for LGBT Health Equity has about 1.5 years left on our CDC contract. After that point, there’s no guarantee CDC will continue the tobacco network funding. Of course, we’re working very hard to clarify the value in having networks like ours who can keep pointing out gaps, keep tabs on what’s happening around the country, and keep the people in touch with the policymakers. Considering the new emphasis on changing health policies I believe the value of networked LGBT communities is higher than ever, because if there’s one thing our communities have built skills in, it’s policy change. But the truth remains, this Network has to become sustainable in a shifting health environment.

As always, our strength is in our people. I’m particularly grateful to the Network Steering Committee members. This group has agonized over the name change, created a media plan, is currently creating a new level of detailed best practices document, and in 2011 spent about half a year creating a draft strategic plan to help guide us through the turbulent years ahead.

Community Review & Our Network

Very soon now, this draft strategic plan will be circulated to our constituency for review and input. I hope each of you can take a few minutes to look at it and think about whether this reflects the Network you want to see. I know how hard the Steering Committee worked on this draft, every single word was agonized over. Our history, our core of tobacco work, the evolution of the arena, what we want, all these things and more were put in the hopper and fashioned into a (deceptively) short set of goals for us to use as our compass in coming years.

Some of you were there in 2003, when 60 people gathered from all around the LGBT communities to create our first tobacco action plan. That document provided the foundation for the Network development and innumerable local programs for years. I feel the development of this strategic plan is a direct outgrowth of that work. I know our world has changed since 2003, but I hope every single person out there concerned with LGBT health, tobacco, and wellness still feels the drive we did back then, to make and keep this Network as one we have built, that represents our joint goals.

So look for that strategic plan to come out for review in a few days, and I hope you’ll take at least a few moments to check it out, and help us make it the best possible guide for the Network that community members built.